骨转换生化标志物的研究进展

Research progress in bone turnover markers

骨转换生化标志物是反映骨骼细胞活性与骨基质代谢水平的生化产物,是在骨骼重建过程中释放于血液或尿液中的生化标志物,包括骨形成生化标志物、骨吸收生化标志物和骨转换调节剂,能较骨密度更早反映全身骨组织的动态变化。其具有敏感性好、特异度高、重复性好、非侵入性、经济适用等特点,是成为代谢性骨病的鉴别诊断、评估疗效、预测骨折风险的重要指标。目前,BALP、P1NP、CTX等指标已广泛应用于临床,一些新的标志物如CXC、GSN、ANXA2等在国外已经有一定研究,但国内临床相关研究较少,其能否作为有效指标反映全身骨组织的动态变化仍需进一步研究,笔者对一些新的骨转换生化标志物研究进展作一简单综述。

Bone turnover markers are biochemical products that reflect the activity of bone cells and the metabolic level of bone matrix.They are biochemical markers released in the blood or urine during the process of bone reconstruction,and they reflect the dynamic changes of bone tissue in the whole body earlier than bone mineral density.They have the characteristics of good sensitivity,high specificity,good reproducibility,non-invasive,and economical and applicable,and have become an important index for the diagnosis of metabolic bone disease,evaluation of therapeutic response,and prediction of fracture risk.So far,bone turnover markers,such as BALP,P1NP,and CTX,have been widely applied in the clinical work.Some novel bone turnover markers,including CXC,GSN,and ANXA2,have been studied aboard,but the study in our country is less.In order to confirm whether they are suitable for effective indicators to reflect the dynamic changes of bone turnover,we review the research progress in these markers.